Jersey finger is an avulsion of the flexor digitorum profundus (FDP) tendon from its insertion on the base of the distal phalanx, occurring at zone 1 of the flexor tendon system. The ring finger is most commonly affected (75%), as its FDP extends furthest during grip when the finger is forcibly hyperextended against resistance (grabbing an opponent's jersey). The avulsed tendon may retract to the palm, carrying a small bony fragment.
Clinical presentation is inability to actively flex the DIP joint, with the DIP joint resting in slight hyperextension. The FDS function (isolated PIP flexion) is preserved. Leddy and Packer classification determines prognosis: Type I (tendon in palm, vascular disruption) requires repair within 7-10 days; Type II (tendon at PIP level with bony fragment) allows repair up to 3 months; Type III (large bony fragment at distal phalanx level) allows delayed repair. Surgical repair through a Brunner incision with transosseous sutures or bone anchor reattachment is the standard treatment.
Forcible DIP hyperextension during tackling avulses the FDP from the distal phalanx in the ring finger, producing inability to flex the DIP with the tendon palpable as a tender mass in the palm or finger; requires urgent surgical reattachment within the window determined by the Leddy classification.
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